Faculty of Biological Sciences, University of Leeds

These pages have been left in this location as a service to the numerous websites around the world which link to this content. The original authors are no longer at the University of Leeds, and the former Centre for Human Biology became the School of Biomedical Sciences which is now part of the Faculty of Biological Sciences.

Introductory Anatomy

Dr D.R.Johnson, Centre for Human Biology

Anatomy is an unusual subject because the material we use
is human. This gives, at one and the same time, a fascination
and a repugnance, simply because the material is human.

'The study of anatomy by dissection requires in its practitioners
the effective suspension or suppression of many normal physical
and emotional responses to the wilful mutilation of the body
of another human being' - Richardson

In other words, in normal society, outside the medical school
we would probably be locked up for dissection, and its not very
nice anyway, is it? The name given to the ability to suppress
physical and emotional responses is 'clinical detachment'. Clinical
detachment is the way in which we deal, as anatomists, with the
repugnant, the distasteful, and what, if we did it to a living
human being, would be criminal. It is acquired slowly, bit by
bit, and to different extents. William Harvey, discoverer of
circulation of the blood, dissected both his father and his sister.
Few of us would wish to be so clinically detached.

If we did it to a living human being is the key phrase.
The cadaver is not a living human being but neither is it a pound
of offal.. Perhaps we should examine our attitude to our own,
and other peoples' bodies.

Man has always been fascinated by the interior of his body.
The first written documents to survive are clay tablets from
around 4000BC in Nineveh. The cuneiform script impressed upon
these tablets can be translated, and tells us many things. Some
tablets are inventories for warehouses, some are the equivalent
of laundry lists, and some tell us about the insides of men and
animals opened in a form of fortune telling - trying to predict
the future.

The next landmark was anatomical detail set down by Galen
in the second century AD. This was meagre, distorted and bore
little relationship to the dissected body.
In the Renaissance a change of attitude occurred: in Italy this
took the form of patronage and the setting up of schools of anatomy,
notably at Padua, and the work of the first two great anatomists,
Leonardo da Vinci and Versalius. Da Vinci's work was hidden until
the late eighteenth century but Versalius De Humani Corpus Fabrica,
published in 1543 was the first anatomy textbook as we know it,
drawn from life (or death), accurate and painstaking.

England, as usual in things European, lagged behind, but Scotland
granted royal patronage to the Edinburgh College of Surgeons
and Barbers in 1506. England followed suit in 1540. (Surgeons
thus have a long connection with barbers: this is because medical
men denied them professional status, and leads to the inverted
snobbery of the consultant surgeon whose title is still MR .
The low status of the surgeon, which dated from the Council of
Tours edict in 1163 whereby the church abhorred the spilling
of blood. Ecclesiastics who were also medics were thus discouraged
from surgery, although they continued to practice medicine, and
subcontracted surgical procedures to others, often barbers, who
performed blood letting, tooth drawing and later midwifery.)

It is at this point that things get complicated and that Anatomy
starts to get a bad name. Part of the patronage given by James
IV of Scotland was the bodies of certain executed criminals for
dissection. In England Henry VIII granted the annual right to
the bodies of four hanged felons. Charles II later increased
this to six . Now bodies had to come from somewhere, but the
conjoining of anatomy and hanging offences was very bad news,
and the basis of an association which lasted until the first
Anatomy act in 1832. Dissection was now a recognised punishment,
a fate worse than death to be added to hanging for the worst
offenders.
The dissections performed on hanged felons were public: indeed
part of the punishment was the delivery from hangman to surgeons
at the gallows following public execution, and later public exhibition
of the open body itself. The punishment replaced the earlier
hanging drawing and quartering, in which the four quarters were
exhibited on spikes in various parts of the city, and differed
only in that it was performed by medical men, and, incidentally
that anatomical knowledge was obtained. This state of affairs
was accepted by surgeons because it was, oddly, good for their
image to achieve royal patronage and to be linked with the law.
In France, incidentally surgeons acquired respectability by the
back door. In 1687 surgeons performed a successful operation
for anal fistula on Louis XIV. It was successful, probably because
they practised for a year on lesser mortals with the same complaint.
In 1752 an act was passed allowing dissection of all murderers
as an alternative to hanging in chains. This was a grisly fate,
the tarred body being suspended in a cage until it fell to pieces.
The object of this and dissection was to deny a grave. After
the act the number of available bodies increased, and the act
itself was pro anatomy in that the execution had to follow smartly
upon conviction, and the body conveyed immediately to the surgeons.
Dissection was described as 'a further terror and peculiar Mark
of Infamy' and 'in no case whatsoever shall the body of any murderer
be suffered to be buried'. The rescue, or attempted rescue of
the corpse was punishable by transportation for seven years.

The act benefited anatomists immediately. In 1775 the royal
college of surgeons acquired eight bodies at once before rigor
mortis had set in: one was 'put in an attitude and allowed to
stiffen' by William Hunter, Professor of Anatomy, flayed and
a mould prepared. A cast from this is still on view at the Royal
Society of Arts in London.
Hunter was a key figure in Anatomy. He ran his own private anatomy
school in Great Windmill St in London where he thought in the
'Parisian manner', each student having access to an individual
corpse. He also set up a museum of human and comparative anatomy.
The Company of Surgeons was 'intellectually stagnant' at this
time, had no hall and was more interested as a City livery company
in giving public dinners than offering public dissection. Despite
this, in the period between 1701-1744, 24 lecturers in anatomy
are known to have been active in London alone. The private schools
had no legal status and no legal source of material. The question
was, where did Hunter, his brother and the other anatomists setting
up private schools get their cadavers - certainly not from official
sources. The suspicion, probably justified, was that people were
being paid to obtain corpses. The corpse was now a commodity:
it had cash value and could be bought and sold. Harvey's solution
of keeping it in the family did not become popular: most anatomists
bought from the gallows or the grave.

Agents representing surgeons would bargain with condemned
prisoners not under sentence of dissection (remember this only
happened for murder: hanging was in vogue for stealing a sheep
or even a loaf) : occasionally prisoners struck a bargain to
pay expenses, to provide for a family or to buy the customary
decent apparel for the hanging. Supply was unreliable, however:
riots at public hangings became common, partly because of the
paltry nature of hanging events, partly from superstition. The
body was often reclaimed by relatives and the unpopular anatomists
stoned, defeated and out of pocket. Competition was often so
fierce that a rival anatomy school carried off the body. Dissection
was unpopular and other medical uses were to be found for a recently
hung body - the cure of scofula, goitre, wens, ulcers, bleeding
tumours, cancers and withered limbs for example. To prevent riots
and disorder the Sheriff of London took all bodies of hanged
men, except those sentenced to dissection, into his own custody
and handed them to the relatives for burial.

However in 1826 592 bodies were dissected by students at London
anatomy schools. Most of these must have come from grave robbers.
The earliest grave robbers seem to have been the surgeons themselves.
In 1721 a clause was inserted into apprentices indentures issued
by the Edinburgh college of surgeons forbidding trainee surgeons
from becoming involved in exhumation. Later, students accompanied
professional body snatchers as observers. In Scotland it was
possible to pay fees in corpses rather than in cash. By the 1780s
the work was left to the professionals -Ressurectionists or Sack'
em up men. A professional gang of 15 body snatchers was rounded
up in Lambeth in 1795 . They worked, winter only, serving 'eight
surgeons of repute' from 30 burial grounds. Corpses cost two
guineas and a crown -£2.35 and children six shillings for
the first foot and nine pence for each extra inch. By 1820 the
cost was up to 20 guineas for an unremarkable corpse for dissection.
Freaks cost a lot more. O'Brien, the Irish giant, well over seven
feet tall, who died in 1783 was bought by John Hunter for £500,
despite his wish to be buried at sea to avoid such a fate. He
now stands in the entrance of the Royal College of Surgeons in
London.

Oddly body snatching was not an offence. The body was not
regarded as property, and, once dead, could not be owned or stolen.
Occasionally a body snatcher would be whipped, on unclear legal
grounds. Only if property - such as a shroud was removed was
the robber a thief.

The grave robbers job was easier if the graves of the poor
were robbed. Pit burials, or mass graves were common, and often
a large square pit up to 20 feet deep would be excavated, filled
with coffins gradually over a period of weeks then closed. Stealing
bodies from such graves cannot have been difficult. The wealthy,
of course could buy a metal coffin (1781), Bribgeman's patent
cast iron coffin (1818) or use a mortsafe - a kind of cage of
iron bars surrounding a tomb. They could also, and did, employ
guards, even armed guards to ensure their eternal rest. The poor,
acting in concert to reduce the cost often had a parish mortsafe
or 'jankers' where bodies were kept until too high for the anatomist
to use.

The demise of the body snatcher is perhaps one of the first
cases of consumerism. Since the law was unable or unwilling to
help, because of the lack of a clear offence, it was left to
the public to intervene. Thus in 1828 two medical students caught
attempting to snatch a body were committed to gaol at their own
request as they were threatened by a large crowd. The following
afternoon a crowd of several hundreds 'assembled round the gaol
, provided with axes'. In Yarmouth, Hereford, Greenwich and Lambeth
(we are now in the age of steam, and rapid reliable transport,
at least by sea) similar scenes ensued. A full scale riot broke
out in an Aberdeen anatomy school in 1832 when a dog unearthed
human remains. The School was looted and burned. The crowd, estimated
at 20,000 denied access to the fire engine.

By the time the Aberdeen Riots took place at least 16 citizens
of Edinburgh had been murdered in order to stock the anatomy
school. Burke and Hare gained a poor living in Edinburgh mending
shoes. When a lodger at Mrs Hare's lodging house died the pair
sold the body to Dr Knox's anatomy school for £7.50. Another
lodger fell ill, and was befuddled with whisky , smothered and
sold for £10. Fifteen more followed.

The riots, the murders and public opinion meant that something
had to be done and the outcome was the 1832 Anatomy Act which
was a key issue in the election of 1832. A key figure behind
this was Jeremy Bentham, founder of University College London.
His idea was essentially that anyone applying to a hospital for
treatment was in effect giving permission for the use of their
body, in the event of a poor result, being available for dissection,
followed by Christian burial. Although forgoing a Christian burial
Bentham was publicly dissected at University College in 1828.
There is a sub text to this. Anyone applying to a hospital for
treatment meant, in effect the poor who could not afford to pay
a doctor. Hospital also meant workhouse. After much argument
with Peel, the Prime Minister and political manoeuvring designed
so that the death rates in the workhouse should not be made public
the bill became law. The situation was now this: the bodies of
those maintained by the state (i.e. in Workhouses) if not claimed
by relatives (for burial at their expense) became the property
of the Anatomist. The fate of these bodies had become, and still
is, anatomical examination - not dissection. Administration was
by an Inspector of Anatomy, working for the Home Office. Unsurprisingly
the residents of workhouses, unconsulted, were not happy with
the act, but powerless to do much about it. Many evaded examination
by signing a declaration that they did not wish to be dissected:
the supply from workhouses was unexpectedly low: there were riots:
there was scandal, maladministration and indecency and plain
mistakes. Burial services and coffins were often rudimentary.
Burial clubs became common - like a Christmas Club - pay so much
a week for your funeral. Just before World War 1 ten percent
of the income of women in Lambeth was set aside for 'Industrial
insurance'. There is still a dread amongst the older generation
of a 'pauper's funeral' The only change to the act, however,
was in response to repeated failure of the anatomists to bury
remains within the stipulated period: the period was extended
in 1871.

We operated under the 1832 act until very recently. What has
changed? Well, the workhouse has gone. From the Anatomists point
of view this meant that the supply of material declined: there
were shortages in the 1920s. The Inspector of Anatomy at the
time suggested 'a modest fee of five shillings' to officials
in mental homes - by then the main source of supply.
At this point something odd happened, perhaps allied to the rise
of socialism and atheism. There was continued outcry against
the bodies of the poor being used, and against token burial services
in token coffins. But there was also a rise in donations. From
almost zero before world war one, to 5% between the wars, then
rising again after world war two to almost 100%. The cause of
this is unknown: it parallels a rise in cremation rather than
burial and perhaps tokens a change in our attitude to our bodies.
Perhaps it parallels the demise of the paupers funeral and the
idea that poverty and misfortune could qualify a person for dismemberment
against their will. Who knows ? But all bodies dissected in Leeds
are now donations.

So what does donation entail? Around 100 people a year from
the area contact us wanting details of this philanthropic act.
We ask only that a letter stating their wish is placed with their
effects. At the time of death we are informed and, if the next
of kin agree, the body (which is technically their property)
is donated to us. If the donation is accepted by a Licensed Teacher
( reasons for refusal include post mortem examination, notifiable
disease, gross over- or underweight and certain diseases which
change the anatomy of the body). The deceased , having been certified
as dead, is collected by an Undertaker and transferred to our
mortuary. After a statutory period (there are constant stories
in the papers of the certified dead waking in the mortuary) the
deceased is given a coded label, undressed, shaved and embalmed
with a mixture of alcohol, formaldehyde and phenol in water.
Embalming fluid is introduced via an artery, usually the femoral
artery in the leg. The process of embalming renders the cadaver
sterile, discourages decomposition and prevents the spread of
disease. The cadaver is then wrapped an placed in a refrigerator
until used.

Certain provisions of the Anatomy Act are taken very seriously
in this University.
First we are obliged, after a statutory period, to bury or cremate
all the remains of Mr X, unless he has given consent that certain
portions are retained as museum specimens. We do not wish to
confuse bits of Mr X with bits of Mr Y. At this point we should
distinguish between the kinds of anatomical specimens you will
see

first of all the cadaver which students may dissect.

Secondly the prosection, where the dissection has already
been done for you. These are either wet specimens ie embalmed
or plastinated -embedded in a plastic resin which leaves them
flexible but dry to the touch.

Thirdly the museum specimen or pot, which, as it name implies
is sealed in a jar.

Fourthly dried bones

Fifthly radiographs, CAT scans etc.

In order to keep all pieces of Mr X together the rule is that
he stays on the same table until finished with. Parts will then
be removed in labelled bags and placed in the mortuary. After
a statutory period all remains will be collected together, placed
in a coffin and buried or cremated according to the wishes of
the deceased. Members of staff attend funerals as a mark of respect.
We must also remember that Mr X was someone's husband, father,
uncle, lover. and treat him accordingly.
A few rules of elementary hygiene are also necessary in anatomy
classes. Wear a white coat, tie your hair back if it is long
and wear plastic gloves if you wish. You will not catch anything
from the corpse, but the embalming fluid irritates some people's
skin and human fat smells. If you come to classes in street clothes
you are guaranteed a seat on the bus home. Do not eat or drink
in anatomy class. The other resource which we have not mentioned
is you, the student. You are young, healthy and alive. Wherever
anatomy can be demonstrated on the living we do so. You will
therefore find yourselves called upon to act as models for your
fellows for all the bits conveniently seen from the outside -
surface anatomy. This means that you should be appropriately
dressed for the relevant classes and be prepared to remove clothing
as necessary. So we are back to Richardson's problem of suppression
of physical and emotional responses. We try to help you with
this by a first class which is really compare and contrast yourselves
with cadavers: we hope that this will breed familiarity, and
familiarity will in turn breed respect rather than contempt.